title: Psychosocial predictors of depression among older African American patients with cancer.
abstract: OBJECTIVE
  To determine whether psychosocial factors predict depression among older African American patients with cancer.
  
  
  METHODS
  A descriptive correlational study.
  
  
  METHODS
  Outpatient oncology clinic of a National Cancer Institute-designated cancer center in the southeastern United States.
  
  
  METHODS
  African American patients with cancer aged 50-88 years.
  
  
  METHODS
  Fisher's exact and Wilcoxon rank-sum tests were used to evaluate differences between patients who were possibly depressed (Geriatric Depression Scale) or not. Multivariate linear regression statistics were used to identify the psychosocial factors that predicted higher depression scores. Education and gender were included as covariates.
  
  
  METHODS
  Religiosity, emotional support, collectivism, perceived stigma, and depression.
  
  
  RESULTS
  Participants (N = 77) had a mean age of 61 years (SD = 8.4), and a majority were well-educated, insured, religiously affiliated, and currently in treatment. Participants who were in the lowest income category, not married, or male had higher depression scores. The multivariable model consisting of organized religion, emotional support, collectivism, education, and gender explained 52% (adjusted R2) of the variation in depression scores. Stigma became insignificant in the multivariable model.
  
  
  CONCLUSIONS
  Psychosocial factors are important predictors of depression. Emotional support and organized religious activities may represent protective factors against depression, whereas collectivism may increase their risk.
  
  
  CONCLUSIONS
  Nurses need to be particularly aware of the potential psychological strain for patients with collectivist values, experienced stigma, disruptions in church attendance, and lack of emotional support. In addition, the treatment plans for these patients should ensure that family members are knowledgeable about cancer, its treatment, and side effects so they are empowered to meet support needs.
  
  
  CONCLUSIONS
  Among older African American patients with cancer, emotional support and reassurance from family and friends that they will not abandon them decreases the likelihood of depressive symptoms and minimizes the impact of stigmatizing responses, but the perception that the illness is placing a strain on the family increases the likelihood of such symptoms. Emotional support likely is a stronger predictor of depressive symptoms than religious service attendance.
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, USA. jhamilto@email.unc.edu
authors.forename: Jill B
authors.initials: JB
authors.lastname: Hamilton
authors.forename: Allison M
authors.initials: AM
authors.lastname: Deal
authors.forename: Angelo D
authors.initials: AD
authors.lastname: Moore
authors.forename: Nakia C
authors.initials: NC
authors.lastname: Best
authors.forename: Kayoll V
authors.initials: KV
authors.lastname: Galbraith
authors.forename: Hyman
authors.initials: H
authors.lastname: Muss
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000451:nursing / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing / Q000523:psychology*; D009859:Oncology Nursing; D011237:Predictive Value of Tests; D011584:Psychology; D012067:Religion; D012944:Social Support; D013240:Stereotyping